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Frequently Asked Questions Insurance

When you enroll in a Medicare Advantage plan, you may not need FEHB coverage because the Medicare Advantage plan will provide you with many of the same benefits. You should review the Medicare Advantage Plan benefits carefully before making a decision to suspend or cancel FEHB coverage. You should contact your retirement system to discuss suspension and reenrollment.

If you are a retiree, you can cancel or reduce your FEGLI life insurance at any time. There is no form; you must mail a signed letter to OPM's Retirement Office at:
U.S. Office of Personnel Management
Retirement Operations Center
P.O. Box 45
Boyers, PA 16017-0045
The cancellation or reduction must be in writing and have an original signature by the insured retiree. Be sure to include your retirement claim number (CSA) or Social Security Number (SSN) and specify what action you want taken. Please note that you cannot increase your coverage after retirement or reinstate coverage that you cancel.

Yes, you may change your FEHB enrollment to any available plan or option at any time beginning 30 days before you become eligible for Medicare. You may use this enrollment change opportunity only once. You may also change your enrollment during the annual Open Season, or because of another event that permits enrollment changes (such as a change in family status).

To continue your health benefits enrollment into retirement, you must: (1) have retired on an immediate annuity (that is, an annuity which begins to accrue no later than one month after the date of your final separation); and (2) have been continuously enrolled (or covered as a family member) in any FEHB Program plan (not necessarily the same plan) for the five years of service immediately preceding retirement, or if less than five years, for all service since your first opportunity to enroll.

You need to complete the SF 2809 if you change your enrollment from Self and Family to Self Only or vice versa.
For example, if you have Self and Family coverage and you plan to keep Self and Family coverage, you do not need to complete any forms. You must let the health plan know the date of the divorce so that your ex-spouse can be removed from your enrollment. If you have Self and Family coverage and you now plan on enrolling in Self Only coverage, you must notify your Human Resources Office. You will have to complete an SF 2809.

The Office of Federal Employees' Group Life Insurance (OFEGLI) is an administrative unit of Metropolitan Life Insurance Company that pays claims for the Federal Employees' Group Life Insurance (FEGLI) Program.
If OFEGLI is paying the beneficiary less than $5,000, the beneficiary will receive a check.
If OFEGLI is paying the beneficiary $5,000 or more, the beneficiary will have a choice of two ways to receive the payment.

A check

A MetLife Total Control Account or (TCA), an interest bearing account set up in the beneficiary's name, with Metropolitan Life Insurance Company (MetLife)

If the beneficiary is receiving $5,000 or more and does not make a decision on how to receive payment, a MetLife Total Control Account will be set up in the beneficiary' s name.
For more information, see the FEGLI Handbook chapter on claims.

Generally, plans under the FEHB Program help pay for the same kind of expenses as Medicare. FEHB plans also provide coverage for emergency care outside of the United States which Medicare doesn't provide. Some FEHB plans also provide coverage for dental and vision care. Medicare covers some orthopedic and prosthetic devices, durable medical equipment, home health care, limited chiropractic services, and some medical supplies, which some FEHB plans may not cover or only partially cover (check your plan brochure for details).

Yes, it is true. As part of the Basic life insurance, employees who are under age 45 get an Extra Benefit at no additional cost. The Extra Benefit doubles the amount of the life insurance payable if you are age 35 or younger. Beginning on your 36th birthday, the Extra Benefit decreases 10% each year until, at age 45, there is no Extra Benefit.

Your life insurance coverage continues for up to 12 months in a LWOP or nonpay status. You do not have to pay any premiums while you are on LWOP unless you are receiving benefits from the Department of Labor, Office of Workers' Compensation Programs.
The life insurance ends at the end of the 12 months with a 31-day extension of coverage and a right to convert to an individual policy.

No, you will pay the same premium as you paid while you were an employee. However, annuitants are paid on a monthly basis so you will pay them at the monthly rate. You may see an increase if you are employed by an agency, such as the Post Office, that contributes additional money towards the total premium. Retirees receive the same government contribution as most Federal employees.

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